Sexual Health Advice - Patient Information Leaflets

Syphilis

What is syphilis?

Syphilis is an infectious disease caused by a bacterium called Treponema pallidum . It is easily passed from one person to another through sexual contact. You can pass syphilis on without knowing you have the infection because symptoms can be mild and you may not notice or recognise them.

How do you get syphilis?

Syphilis is a sexually transmitted disease. The infection is passed from person to person through contact with a syphilis ulcer (described below). Depending on where the ulcer is the infection can be passed on during vaginal, anal or oral sex or if you share sex toys. Using a condom correctly will reduce your chance of getting and passing on syphilis. It is not spread by toilet seats, door knobs, bath tubs, shared clothing, baths or towels, hugging or from swimming pools.

Syphilis can be transmitted by blood transfusion. All blood donors in the UK are screened to prevent this.

If you are pregnant, you can pass on syphilis to your unborn baby (congenital syphilis). This can cause serious problems in the baby.

What are the symptoms of syphilis?

The signs and symptoms are the same in both men and women. They can be difficult to recognise and can be missed. If left untreated, the infection typically follows a pattern of four stages. These stages are called primary syphilis, secondary syphilis, the latent period, and tertiary syphilis.

Primary syphilis

Typically, one small ulcer (sore or chancre) develops where syphilis bacteria enter the body. This is commonly on the penis in men, on the vulva or vagina in women, or on the anus. The ulcer usually appears about 2 – 3 weeks after having sex with an infected person, but it may appear anytime up to three months later. The ulcer is usually painless, about the size of a small coin. A clear fluid (serum) may come from the ulcer. The ulcer is very infectious and may take up to 6 weeks to heal. By this time the syphilis bacteria will have spread to other parts of the body.

Sometimes the primary stage is non-typical. For example:

You may have more than one ulcer

The ulcer may be painful

Pus may come from an ulcer

The ulcer may be in your mouth (if you catch the infection during oral sex) or in the rectum (from anal sex)

The ulcer may be on the cervix in women, and is not seen or felt

You may have no symptoms or very mild symptoms that you take little notice of

Secondary syphilis

If the primary ulcer is not treated, or not noticed, secondary syphilis usually occurs within weeks of the ulcer appearing. The symptoms include:

A rash which looks like dark patches that appears on the skin, each about the size of a penny. The rash may spread all over the body, or may be in patches. The palms of the hands and soles of the feet are almost always involved. The rash is not usually itchy or painful.

Wart-like growths may develop around the penis in men, or vagina in women (condylomata lata) or the anus in both men and women.

A flu like illness, tiredness, swollen glands (can last weeks to months).

White patches on tongue or roof of mouth.

Patchy hair loss.

Less commonly, inflammation may develop in other parts of your body such as the liver.

Without treatment, the rash and other symptoms from secondary syphilis usually go after several weeks. However, they may ‘come and go' for up to two years.

Secondary syphilis is very infectious.

Latent (hidden) syphilis

After the symptoms of secondary syphilis have cleared, you may not have any symptoms for several years. In this ‘latent' period you may think that the disease has gone. In some cases, there is no further development.

Tertiary syphilis

After many years untreated syphilis may cause very serious damage to the brain and nerves, heart, bones, blood vessels, liver, eyes and skin. At this stage syphilis can be fatal.

How is syphilis diagnosed?

A swab can be used to collect a sample of fluid from any sores.
If there are no sores, a blood test can detect syphilis.
You can have the test as soon as you think you might have been in contact with syphilis. The results of the blood test will usually be known within 3 days. For some people syphilis will not show up on the test straight away so it will be repeated at a later appointment.

How will I know how long I have had syphilis infection?

It can be impossible to know, particularly if you have not had any symptoms. You might never know whether you got syphilis from your current or a previous sexual partner. This can often be difficult to handle. Do not be afraid to talk to clinic staff about how you feel.

What is the treatment for syphilis?

A course of penicillin injections over 10 – 14 days is the usual treatment. This kills the bacteria and prevents the disease from progressing any further. Treatment during the primary of secondary stages of the disease should cure the infection and usually prevent any permanent long-term damage.

Other antibiotics are used if you are allergic to penicillin.

Some of the antibiotics used to treat syphilis interact with the combined oral contraceptive pill. So inform the doctor or nurse if you are taking the pill so they can advise you what to do.

There are no treatments that you can buy over the counter without a prescription that can cure syphilis.

Avoid vaginal, anal or oral sex until you and your partner have both finished treatment, otherwise you could be re-infected. Using a condom will reduce the risk of re-infection but it does not guarantee it.

Can syphilis be prevent?

If you practice safe sex, and always use a condom, your risk of catching syphilis is very much reduced. However, condoms do not provide complete protection, as syphilis ulcers can sometimes be on areas not covered by a condom.

If you have had syphilis, and had it treated, you can still get it again if you have sex with an infected person.

Should I tell my partner about my syphilis?

If you have syphilis it is very important that your current sexual partner and any other recent partners are tested and treated.

The staff at the clinic can discuss with you now you might tell your partner(s). If you find this too difficult the clinic can notify your partner for you. Your confidentiality will be protected at all times.

It is strongly advised you do tell your partner(s) but it is not compulsory.

Can syphilis go away without treatment?

No. If you delay seeking treatment you may pass the infection on to someone else. You also risk the infection causing long term damage.

What happens if I get syphilis when I am pregnant?

All pregnant women are offered an antenatal blood test to detect syphilis. If you are found to have syphilis then treatment can be given safely during pregnancy with no risk to the unborn baby. If a woman has untreated syphilis she may pass the infection to her baby in the womb. This can lead to miscarriage, stillbirth or the baby being born with the infection.

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